HomeMy WebLinkAbout1307 Declaration of Domicile and Citizenship
5C1f 264
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COU~Y, ~,p~A;
This is mT deeLration d Domicile and Citisenship is the State d Florida that I am 51inE this dq io aooordana, and in
coniormitT with Section 222.17. Florida Statutes.
I was loaner a legal resident o1 A ~ L . and I
tc~cr? ~ew.~
resided ~ Hewever. I have changed mT domietis to
18t~Mt sad I~onbK) {
and am and have been a bona Ede resident d the State d Florida since dad d
19~~ and I reside at _~L3 ~/~~~~'N~
i ~ ST. LUG 1 E a~aN~
(aRsl Connti. Florida.
and this statement is to bs ta><en as ~ daelaration d dt~enship. actual legal rssidena and domicile is tbs State d 1E7oeids.
" IF fOR THE PURPOSE OP ENROLLING Ii FOR NOMESTEAO PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES: -
- fllED AlID P,f~''~DEO
-
,~,y `t QQ Qua r~~
5 X264
I FURTHER CERTIFY that I w~ register at mT kxsil address when the registration books reopen. and oompiT with an
other regniremeats d a legal resident d this State.
f
I FURTHER CERTII!'Y that I have m intention to ret~an to former dominle. and I intend to remain in
_ _ UC1E _~T,
Florida. permaaentl; - • ;
V.......- .J
L/` . .-E`
'~(;ti.'i
- Swoea to and aubeQibed betae+a me this dq d
_.A.D.l!iZ~. 1~bN/UA ~A~~43/le~ .
- _
l~OGER PO1'iRAS. CLER OF C IRGUI T COt~12T .
ST. LUG I E COUNTY, fLOR t OA ~ ~ ~ . .
- ~ ~
_ - BY: -
~ EPUTY LER
-
_ ,
J
. ~n r i
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